1. Field of the Invention
This invention relates to an apparatus for applying surgical clips to body tissue during laparoscopic or endoscopic procedures, and more particularly, to a surgical clip applier configured for selective operation such that in a first mode the feed of a clip into the jaws is initiated by the user and in a second mode it is initiated independent of the user.
2. Description of Related Art
In laparoscopic and endoscopic surgical procedures, a small incision is made in the patient's body to provide access for a tube or cannula device. Once extended into the patient's body, the cannula allows insertion of various surgical instruments for acting on organs, blood vessels, ducts, or body tissue within the body cavity. Often during these procedures, it is necessary to apply hemostatic clips to blood vessels or ducts to prevent the flow of body fluids therethrough. Instruments for performing endoscopic surgical clip application are known in the art, and include both single clip and multiple clip appliers.
Endoscopic multiple clip appliers known in the art are described in U.S Pat. Nos. 5,084,057 and 5,100,042, the disclosures of which are incorporated herein by reference. In a commercially available embodiment of the invention of the '057 and '420 patents, the Auto Suture* Endo Clip* applier, a clip pusher is provided for individually advancing a clip from an array of stored clips towards a pair of distal jaw members. As each clip is formed by the jaw members, the clip pusher is drawn proximally to a position proximal to the distal-most clip in the clip array. The clip pusher is maintained in this position by a catch mechanism in the frame of the apparatus. At a desired time, the user of the instrument releases the catch mechanism, e.g., by actuating a trigger associated with the frame, thereby freeing the clip pusher to feed the distal-most clip into the jaw members. Thereupon, the jaw members may again be closed to form the clip. The maintenance of the clip pusher in a position proximal to the next clip until the user releases the catch mechanism is advantageous for several reasons, including the fact that the jaws will be empty of a clip for tissue dissection and for passage into and out of a trocar sleeve.
Another multiple clip applier for use in an endoscopic surgical procedure is disclosed in U.S. Pat. No. 5,112,343 to Thornton. As with the commercially available Endo Clip* applier, the Thornton device includes a mechanism which enables the user to select the point in time when a clip is to be advanced to the jaws. The mechanism includes a button 100 which is pressed by the user to release a drive link to feed a clip into the jaws. The Thornton device is intended, inter alia, to reduce the risk that a clip waiting in the jaws may be dislodged and fall into the body (see col. 1, lines 44-59).
A second commercially available endoscopic multiple clip applier, the Ethicon Ligaclip, duplicates the structure, function and use of the Endo Clip* applier with one exception, the catch mechanism in the frame is omitted. Thus, after a clip is formed by the jaws, the clip pusher places the next clip in the jaws without further action by the user. Although offering the potential for relatively small time savings during a surgical procedure, the Ligaclip suffers from the disadvantage that a clip is present in the jaws at all times, including times when the user would prefer that the jaws be empty.
It is an object of the subject invention to provide a surgical clip applier for applying multiple clips during endoscopic or laparoscopic procedures which is configured for selective operation, such that in a first mode the feed of a clip into the jaws is initiated by the user and in a second mode it is initiated independent of the user.
It is another object of the subject invention to provide a surgical clip applier for applying multiple clips during endoscopic or laparoscopic procedures which provides the user with a mechanism for selecting between the two modes of operation described above.
These and other objects of the subject invention will become more readily apparent from the following description of the invention.